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Individual
MRS. GLENDA FAYE GANUS
Active
Individual
MRS. GLENDA FAYE GANUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-031341
AL
363L00000X
Nurse Practitioner
R856711
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051516689
MEDICARE ID
AL
05
—
529700760
—
AL
01
—
541003926
MEDICAID GROUP
AL
Enumeration date
07/29/2005
Last updated
02/22/2016
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